HHH column: Ivory manikin of a pregnant woman: ex voto or anatomical model? by Arie Kruseman

The HHH column is a monthly blog in which History, Health & Healing members share their thoughts on research, current affairs, or anything to do with medical history. Each edition is written by a different member – in due time, we hope to offer everybody a chance to publish a contributionThis month, the floor is for Arie Nieuwenhuijzen Kruseman, emeritus professor of Medicine and Endocrinology and secretary of the Foundation Historia Medicinae. In this column, he investigates the history of a mysterious ivory manikin.

Arie Nieuwenhuijzen Kruseman

Ivory manikin of a pregnant woman: ex voto or anatomical model?

Among the objects my father – who was a gynaecologist – left me I found an ivory manikin of a pregnant woman (figure 1).

Figure 1

This manikin is 19 cm long and lies on a bed of ebony. The head is on a pillow that is also made of ivory. The arms are mobile at the level of the shoulder joint. The right arm is bent at right angles and covers the abdomen, the left arm is slightly bent and covers the pubic area. When the arms are raised, the chest-abdominal wall can be removed and a loose intestinal package becomes visible, covering a loose model of a foetus (figure 2).

Figure 2

In the cardboard box in which the model was stored, there was a handwritten note:

The medical school of the University of Padua put into circulation in the 13th century ivory models of pregnant women for instruction. These models were copied for presents and ex voto: a present for the church as confirmation for pleas for pregnancy or to thank certain saints when the pleas were heard. These models remained in use until the 16th century.

It is not clear to me how my father obtained this model. The handwritten text is not his handwriting and, on the basis of literature on anatomical models of ivory, it is not correct. The development of anatomical models started in Europe after the publication of De humani corporis fabrica by Andreas Vesalius in 1543. There is also no information in the literature that the medical faculty of the University of Padua played a role in the development of ivory anatomical models. Anatomical models as an ex voto or votive offering to a saint for obtaining a favour or giving thanks consisted mostly of a wax image of a body part for which the favour was requested. After obtaining the favour, the image was then melted down for reuse. In case of a pregnancy after a long period of infertility, the votive gift often consisted of a wax model of a baby, not a model of a body containing a baby.

Development and production of ivory anatomical models

There are about 150 known anatomical models as the one described above. Although none of these models are signed and dated, the majority was likely produced in the late 17th and early 18th century in the workshop of the ivory cutter Stephan Zick (1639-1715) at Nuremberg in Germany. Some were made in the studio of Johann Michael Hahn (1714-1793) who worked in Schweinfurt with his sons Adam and Conrad and who, like Zick, was already familiar with the production of ivory eyes and ears. There are no French and Italian ivory cutters of anatomical models known.

The models made in Zick’s workshop are characterised by a typical style. A head of hair that fits the fashion of the late 17th century, a wide little finger, dimples in the knuckles, a red umbilical cord, pointed feet, a split kneecap, and the left arm perpendicular in flexion (figure 3).

Figure 3

In 1970, based on characteristics of 98 then known models, a scholar named K.F. Russell classified them into 7 groups and attempted on the basis of this to determine their origin. The model I found in my father’s inheritance does not fit into any of these groups. In contrast to the models classified by Russell, in this model the right arm instead of the left arm is in an angled flexed position and only a few of the characteristics described for the models from Zick’s studio are present. Instead, the model is very similar to a model described in 1985 by B. Thomas in his monograph on ‘Anatomical Modelle aus Elfenbein’ of the Medezinhistorisches Institut of the University of Zürich (figure 4), not included in the series of Russell and made by an unknown ivory cutter.

Figure 4

Function and significance of anatomical models of the pregnant woman

No sources are available that unambiguously describe the function and meaning of ivory anatomical models. Any explanation of their function and meaning is therefore speculative. Although the structure of the body of pregnant women in ivory models is represented three-dimensionally, these models are too small for representation of organs in detail. Therefore, these types of models are unsuitable for anatomical education. It is unlikely that these models have been developed for the education of students or midwives. Much more likely, these models served to educate the public about the differences between males and females and about pregnancy. In a 1927 publication, Crummer describes a patient who, as a bride in 1865, was informed about the physiology of pregnancy with the help of an ivory anatomical model of a pregnant woman. In addition, these models were likely collectibles for the wealthy in Europe.  Already in the oldest civilizations ivory was used for the manufacture of figurines. The heyday of ivory sculptures was the 14th century. But even afterwards, the durability and value of this material will have contributed to the status of the owner of an ivory model. Not without reason, a person’s 100th birthday is called an ivory jubilee and a marriage lasting more than 62 years an ivory marriage.

Literature consulted

Buckley C: Crafting the image of the human body: the development of interactive anatomic models in early modern Europe. PhD Thesis Pensylvania State University, august 2017

Crummer LR: Visceral manikins in carved ivory. American Journal of Obstetrics and Gynecology, 1927; 13:29-32

Russel KF: Ivory anatomical Manikins. Medical History, 1972;16:131-142

Thomas B: Anatomische Modelle aus Elfenbein. Zürcher MedizingeschichlicheAbhandelungen, neue reihe, nr 178.  Juris Druck + Verlag Zürich, 1985

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